Who feels affected by “out of control” sexual behavior? Prevalence and correlates of indicators for ICD-11 Compulsive Sexual Behavior Disorder in the German Health and Sexuality Survey (GeSiD)

Abstract

Background and aims The purpose of this study was to examine the prevalence and correlates of indicators consistent with Compulsive Sexual Behavior Disorder (CSBD)—defined and operationalized according to the ICD-11 guidelines—in a large (n = 4,633; 50.5% male; 49,5% female) probability-based German national sample. Methods Participants were asked if they had ever experienced “intense and recurring sexual impulses or sexual urges that I had difficulty controlling and resulted in sexual behavior” over a period of several months. Those who reported this experience were queried about the associated distress. Results Overall, 4.9% of men [95% CI = 3.9–6.1] and 3.0% of women [95% CI = 2.3–3.9] reported experiences consistent with ICD-11 diagnostic requirements for lifetime diagnosis. In the 12 months preceding the study, 3.2% of men [95% CI = 2.4–4.2] and 1.8% of women [95% CI = 1.2–2.5] reported experiences consistent with CSBD requirements. Compared to controls and participants who reported elements of compulsive sexuality but without accompanying distress, strict religious upbringing was most prevalent in the CSBD group. The CSBD group was more likely to view sexual practices like men having sex with men as unacceptable and to report the belief that pornography has negative impacts on their sex life and life in general. Compared to the other two groups, the CSBD group was significantly more likely to have received psychiatric treatment for depression or another mental health problem during the past 12 months. Discussion and conclusions The current study provides novel and important insights into the prevalence and characteristics of CSBD in the general population.

Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review

“…Since the diagnostic instruments used varied remarkably in the past (from single items to elaborated questionnaires), prevalence estimates of CSBD and PPU also cover a broader range. Studies reported prevalence rates for CSBD of 4.2–7% in men and 0–5.5% in women ( Bőthe et al, 2020b ; Briken et al, 2022 ; Fuss, Briken, Stein, & Lochner, 2019 ) and similarly for PPU of 3–10% in men and from 1 to 7% in women ( Bőthe, Potenza, et al., 2020 ; Grubbs, Kraus, & Perry, 2019 ; Lewczuk, Glica, Nowakowska, Gola, & Grubbs, 2020 ).…”

Problematic pornography use across countries, genders, and sexual orientations: Insights from the International Sex Survey and comparison of different assessment tools

“…due to moral incongruence) and PPU due to behavioral dysregulation, using personcentered approaches and clinical assessments. More in-depth analyses of the complex roles that cultural values, religiosity, the content of pornography, or moral perspectives may play in diagnosing PPU are also recommended [4,5,24,93]. Furthermore, even though the results of traditional MI testing suggested the lack of potential measurement biases, and thus the adequacy of using all three scales in different populations, it should be noted that besides its strengths, this method also has its weaknesses [94][95][96][97].…”

Problematic pornography use and suicidal thoughts: Results from cross-sectional and longitudinal analyses.

“…A recent representative sample of German nationals indicated that 4.9% of men and 3.0% of women reported experiences consistent with diagnostic criteria for CSBD (Briken et al, 2022). Other nonepidemiological studies find a similar percentage of Americans report concerns about their sexual behaviors being out of control (Dickenson et al, 2018).…”